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Psychometric Evaluation of the Turkish Version of the Dental Fear Survey
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Akdeniz University, Antalya, Türkiye.
Introduction And Aims:
Dental fear is an important barrier to dental attendance and may affect oral health behaviours, treatment acceptance and patient-centred care. The Dental Fear Survey (DFS) is a widely used multidimensional instrument. Although the DFS has previously been used in Turkish populations, comprehensive psychometric evidence for a systematically adapted Turkish version in adult clinical patients has remained limited. This study aimed to translate and culturally adapt the DFS into Turkish and evaluate its psychometric properties.
Methods:
The DFS was translated and culturally adapted following established guidelines. The prefinal version was pilot-tested in 30 adult dental patients, and content validity was evaluated by 10 experts. The main evaluation included 502 adult dental patients, divided into independent EFA (n = 253) and CFA (n = 249) subsamples. Internal consistency, 2-week test-retest reliability in 50 patients and convergent validity with the Turkish Modified Dental Anxiety Scale were assessed.
Results:
EFA suggested a meaningful 3-factor structure consisting of dental avoidance and anticipatory anxiety, physiological arousal and fear of specific dental stimuli and procedures, explaining 66.99% of the variance. CFA showed improved but limited fit after theoretically justified modifications; therefore, the 3-factor structure was interpreted cautiously. Internal consistency was excellent (Cronbach's alpha = 0.95 for the total scale; 0.81-0.95 for subscales). Test-retest reliability was also excellent (ICC = 0.98 for the total score; 0.96-0.98 for subscales). The total DFS score correlated strongly with the MDAS score (r = 0.83, P < .001).
Conclusion:
The Turkish DFS demonstrated favourable psychometric properties, particularly for internal consistency, temporal stability and convergent validity. Its multidimensional structure was meaningful, although structural validity should be interpreted cautiously and confirmed in independent samples.
Clinical Relevance:
The Turkish DFS may facilitate clinicians identify components of dental fear and support patient communication and assessment in Turkish-speaking adults.
